Immune-instructive materials and surfaces for medical applications

Fisher, Leanne E.; Ghaemmaghami, Amir M.

Abstract

Biomaterials are an integral part of modern medicine with diverse applications including drug delivery platforms, scaffolds for tissue engineering, biosensors and medical devices/implants. The aging population and steady increase in the prevalence of chronic diseases means that the use of biomaterials for medical applications will continue to increase. Impairment, failure and rejection of implants due to infection or adverse immune responses, resulting in chronic inflammation, are major barriers to the clinical success of implanted biomaterials. Upon implantation of a medical device, the host response to the biomaterial, also known as a foreign body response (FBR), ensues. The FBR involves a complex cascade of immune responses, involving various cell types and soluble mediators. Studies have shown that antigen presenting cells (APCs) such as macrophages and leukocytes such as neutrophils play a crucial role in orchestrating immune responses against foreign materials. The activation status of APCs can determine the outcome of an immune response following exposure to a foreign material and bring about either healing and integration or chronic inflammation and fibrosis. In nature, we find many natural materials that have cell instructive properties, which can direct the outcome of a FBR by inducing innate immune cells to release a wide range of pro- and antiinflammatory cytokines, chemokines and growth factors. Similarly, we find many synthetic materials, which also have immune-modulatory properties. However, challenges persist in predicting whether a material will elicit a pro- or antiinflammatory responses in-vivo. The development of novel surfaces and materials able to regulate immune cell function and direct their fate is pivotal for engineering smart implants if adverse events are to be avoided. It is well known that both chemical and physical cues have a great influence on functions of both prokaryotic and eukaryotic cells, by triggering specific molecular events at the cell-material interface. Thus, controlling biomaterial surface attributes provides a way to modulate the activity, phenotype and function of immune cells. This gives potential to reduce detrimental proinflammatory responses and promote beneficial prohealing ones. Discovery and development of new biomaterials with immune-instructive properties would be of huge benefit to the many patients requiring medical device intervention. This chapter discusses the FBR in the context of medical devices and the role that different immune cells play in inflammation, resolution, and the healing process. Examples of natural and synthetic derived materials for medical device application and how tuning biomaterials to elicit immune modulatory properties will be examined, along with how they have been used to reduce the FBR.

Citation

Fisher, L. E., & Ghaemmaghami, A. M. (2021). Immune-instructive materials and surfaces for medical applications. In S. F. Badylak, & J. H. Elisseeff (Eds.), Immunomodulatory Biomaterials: Regulating the Immune Response with Biomaterials to Affect Clinical Outcome (67-87). Elsevier. https://doi.org/10.1016/B978-0-12-821440-4.00008-6

• Publication Date: 2021
• Deposit Date: Aug 19, 2022
• Publisher: Elsevier
• Pages: 67-87
• Series Title: Woodhead Publishing Series in Biomaterials
• Book Title: Immunomodulatory Biomaterials: Regulating the Immune Response with Biomaterials to Affect Clinical Outcome
• ISBN: 9780128214404
• DOI: https://doi.org/10.1016/B978-0-12-821440-4.00008-6
• Public URL: https://nottingham-repository.worktribe.com/output/7761175
• Publisher URL: https://www.sciencedirect.com/science/article/pii/B9780128214404000086?via%3Dihub